| Objective:To investigate the prevalence and characteristics of depression in patients with Parkinson disease.Researching its related factors and the degree of relevance.Finding out the main influence factors on the quality of life in Parkinson’s disease patients,and laying the foundation for the further study of Parkinson’s disease with depression and the clinical diagnosis and treatments.Methods:1.This study included 127 patients with Parkinson’s disease in the Department of Neurology,Sichuan Provincial People’s Hospital,from June 2016 to May 2017.In order to avoid the impact of extreme values on the statistical results,patients with equivalent doses of levodopa of 2000 mg and 4589 mg were excluded,and the remaining effective samples were 125.2.The basic information of patients with Parkinson’s disease was collected to collect basic information,including gender,age,education,age of onset,duration of disease and drug use.The equivalent dose of levodopa is obtained by the conversion of the drugs,and the age of the disease is divided into early and late stages.Hamilton Depression Scale(HAMD)was used to evaluate the patient’s depression.Unified Parkinson’s disease Rating Scale(UPDRS)Ⅲ was used to assess patients’ motor symptoms;The Modified Hoehn-Yahr Staging was used to assess the severity of the patient’s condition,which was divided into early and Mid-late stages.The patients were divided into three subtypes of motor symptoms,such as PIGD,TD and mixed type.The Scale For Outcomes in PD For Autonomic Symptoms(SCOPA-AUT),Minimum Mental State Examination(MMSE),Montreal cognitive assessment scale(Mo CA),Pittsburgh sleep quality index(PSQI),The Epworth Sleeping Scale(ESS),Rapid eye movement sleep behavior disorder screening questionnaire(RBDSQ),Fatigue Scale-14(FS-14),and King’s PD Pain Scale(KPPS)were used to evaluate other non-motor symptoms of the patients.Among them,ESS and RBDSQ were used to assess whether patients were combined with Excessive daytime sleepiness(EDS)and Rapid eye movement sleep behavior disorder(RBD).3.According to the HAMD score is not greater than or equal to 8,125 patients were divided into depression group(GD)and non-depression group(NGD).We compared whether the differences between the two groups were statistically significant.Then we incorporate the factors of statistical difference into the forward Wald multiple factor Logistic regression,and analyze the main factors.We used the PDQ-39 score after the normal transformation as the dependent variable,and used Multiple linear regression analysis to study the influence of various factors on the quality of life in PD patients,then found out the main influencing factors.Data entry was done by Excel form.Statistical analysis was carried out by SPSS23.0 software.Quantitative data were checked by t test or rank sum test,and qualitative data was checked by chi square test.The difference of P<0.05 was statistically significant.Result: A total of 125 patients were included in this study,and the proportion of men and women was 1.45:1.The HAMD score was between 0 to 46,89 in the depression group and 36 in the non-depression group.The incidence of depression was 71.2%.Among them,66.3% in the mild depression group,28.1% in the moderate depression group and 5.6% in the severe depression group.Through statistical analysis,there was no statistical difference in gender(χ~2=0.016),age(t=-0.218),educational background(χ~2=6.322)and onset age(χ~2=0.168)between the two groups.There was statistical difference between the two groups in terms of duration(z=-3.047)and equivalent dose(z=-2.205).Among the two groups,there were statistically significant differences in UPDRSⅢ(z=-4.220)and H-Y grades(χ~2=6.053)among the exercise symptoms,and there was no statistical difference in the subtypes of motor symptoms(χ~2=3.274)between the two groups.Among the non-motor symptoms,there were significant differences in SCOPA-AUT score(z=-3.968),MMSE score(z=-3.359),Mo CA score(z=-2.910),PSQI score(t=-3.985),whether there was EDS(χ~2=9.089),FS-14 score(z=-4.972)and KPPS score(z=-2.949)between the two groups,and there was no statistical difference between the two groups with the combination of RBD(χ~2=0.276).Finally,the factors with statistical difference were included in stepwise multivariate Logistic regression analysis.The variables included in the equation were duration,SCOPA-AUT,MMSE and FS-14 score.The regression equation is logit(P)=1.575+0.176 × X1+0.077 × X5-0.165 × X6+0.200 × X10 。Hosmer-Lemeshow goodness of fit test χ~2=5.992,P =0.648> 0.05.Then we carry out the ROC analysis and draw the ROC curve.The area under the calculated curve is 0.858,and the accuracy of the model is high.The PDQ-39 score is determined by the normality test as the partial distribution data,so the normal transformation is carried out,then we obtained variable SQRT(PDQ-39).With SQRT(PDQ-39)as the dependent variable,all the factors collected are independent variables,and the linear regression analysis is carried out one by one.The variables of P<0.1 were selected and the variables selected were included in the multivariate linear regression analysis.The variables that were eventually incorporated into the equation were H-Y grading,UPDRSⅢ,SCOPA-AUT,Mo CA and FS-14 scores.The regression equation is Y=2.945+0.058×X1+0.676×X2+0.050×X3-0.097×X4+0.093×X5.The whole model is adjusted by R2=0.476.Conclusion: The incidence of depression in Parkinson’s disease is high and mainly with mild depression.The main factors affecting depression were the course of the disease,autonomic dysfunction,cognitive dysfunction and fatigue.The main factors affecting the quality of life were motor symptoms,severity of the disease,autonomic nervous dysfunction,cognitive dysfunction and fatigue.It is helpful to reduce the incidence of depression and improve the quality of life of patients with Parkinson’s disease by increasing the emphasis on the incidence of depression,timely diagnosis,early treatment and intervening other related factors that may affect the living ability of patients. |
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